Diabetes management system

ABSTRACT

A method of diabetes management, comprising (a) providing a remote communications unit in communication with a portable microprocessor-based unit; (b) transmitting blood glucose level data into the portable microprocessor-based unit or the remote unit, or both; (c) running a program of instructions on the portable microprocessor-based unit or on the remote unit, or both, using data corresponding to the blood glucose level data; and (d) providing a signal including instructions to inject insulin when the blood glucose level data indicates.

RELATED APPLICATIONS

This application is a Continuation of application Ser. No. 11/748,031,filed May 14, 2007, which is a Continuation of application Ser. No.11/583,433, filed Oct. 19, 2006, which is a Divisional of applicationSer. No. 10/673,045, filed Sep. 26, 2003, which is a Continuation ofapplication Ser. No. 09/971,785, filed Oct. 4, 2001, now abandoned,which is a Continuation of application Ser. No. 09/119,546 filed Jul.20, 1998, now U.S. Pat. No. 6,330,426, which is a Continuation-In-Partof application Ser. No. 08/953,883 filed Oct. 20, 1997, now abandoned,which is a Continuation-In-Part of application Ser. No. 08/757,129 filedDec. 3, 1996, now U.S. Pat. No. 6,144,837, which is aContinuation-In-Part of U.S. application Ser. No. 08/334,643, filed onNov. 4, 1994, now U.S. Pat. No. 5,601,435; and the application Ser. No.09/119,546 filed Jul. 20, 1998, now U.S. Pat. No. 6,330,426, is also aContinuation of application Ser. No. 08/958,786, filed Oct. 29, 1997,now U.S. Pat. No. 5,913,310, which is a Continuation-In-Part ofapplication Ser. No. 08/857,187, filed May 15, 1997, now U.S. Pat. No.5,918,603, which is a Divisional of application Ser. No. 08/247,716,filed May 23, 1994, now U.S. Pat. No. 5,678,571. All of the aboveapplications are hereby incorporated by reference.

FIELD OF THE INVENTION

The present invention relates to the field of medical treatment, and inparticular to the treatment of medical conditions in human patients.

BACKGROUND OF THE INVENTION

One of the biggest problems many healthcare providers face is theirpatients' lack of knowledge. Patients may lack knowledge on basicpreventative measures, such as why they should exercise, eat right, andnot smoke. Patients may also lack knowledge on conditions or diseasesthey do have, such as how to measure their blood glucose levels if theyare diabetic. This lack of knowledge is a problem for healthcareproviders because patients who do not know how to take care ofthemselves are ill more frequently. Thus, they must visit their doctorsmore often, sometimes incurring additional costs for hospital stays orlaboratory tests. This results in greater fees for the patient, his orher insurance company, and often the taxpayers.

An example of this problem is seen in some diabetes patients. Diabeticpatients must regularly receive insulin shots and adhere to a specificdiet in order to control their blood glucose levels. Unfortunately, somediabetic patients do not understand all the reasons why they should haveregular insulin shots or why they should or should not eat certainfoods. In addition, many diabetic patients are unaware of the healthconsequences should they not follow their treatment plan. As a result,such patients are sicker and require more healthcare than those patientswho understand all aspects of their diseases. Sicker patients requiremore healthcare, which is expensive and time-consuming for healthcareprofessionals, insurance companies, and the patients themselves.

One way this problem is handled is by increasing the amount of educationpatients receive about their lifestyle choices and/or their diseases.When patients know what they need to do to stay healthy, they are lessinclined to visit their doctors as frequently. In addition, if patientsunderstand the health problems that will result from not taking care ofthemselves, they will be more likely to follow their prescribedtreatments.

Educational forms range from pamphlets in a doctor's office to radioannouncements to television shows. Paper-based educational material ischeap, easy to produce, and easy to distribute. Unfortunately, pamphletsor articles are limited to words and pictures and are usually quiteboring, which makes it unlikely that patients will enjoy and rememberreading them. Radio announcements and television shows are more livelyand entertaining, but they are broadcast to the general public. Thusthey cannot be customized to a particular patient.

Due to technological advances, patients can now be educated usingCD-ROMs, the Internet, and multimedia processors. U.S. Pat. No.5,307,263 by the present inventor discloses a modular,microprocessor-based health monitoring system. The hand-held unit has adisplay screen, a control button pad, interchangeable programcartridges, and sensors for monitoring a variety of healthcare data. Theprogram cartridges include motivational and educational material relatedto use of the device, including step-by-step instructions. Acquired datamay be transmitted to a data management unit via an interface cable, orto a clearing house via telephone lines. A program cartridge formonitoring glucose levels and a glucose sensor is disclosed for thepurpose of caring for children with diabetes.

U.S. Pat. Nos. 5,597,307 and 5,624,265 by Redford and Stem describe aneducational system and apparatus aimed at children which also uses amultimedia processor. This invention comprises a remote control locatedin a book or other printed publication. A child can read the book whilewatching the display generated by the multimedia processor, and thenpress the buttons in the remote control book to alter what he sees.

None of the above education systems allow an individual to automaticallyaccess assigned educational programs remotely. The inventions describedabove provide general educational programs which are not tailored to anyone individual. Neither system provides confirmation that an individualhas completed the educational program. Neither system allows ahealthcare provider nor teacher to easily custom-design whicheducational programs a patient or individual is to view. Finally,neither system provides a patient or individual access to an unlimitednumber of educational programs.

Medical conditions associated with a patient's behavior pattern orwell-being are typically evaluated and treated in therapy sessionsconducted by a physician or a health care specialist. Depending on theailment, a preliminary picture of the patient's condition may beavailable to the specialist in the form of answers to questionnaires orresults of a battery of tests. This applies to psychological conditionssuch as schizophrenia, depression, hyperactivity, phobias, panicattacks, anxiety, overeating, and other psychological disorders. Infact, the number of diagnostic tests presently available for classifyingthese conditions is vast. Such tests rely on the patient to perform aself-examination and to respond candidly to a series of personalquestions. Since most tests differ in their basic scientific assumptionsthe results obtained are not standardized and can not often be used tomake meaningful case comparisons.

Consequently, the above-mentioned psychological conditions are fullydiagnosed and treated in therapy sessions. In these settings thespecialist can better evaluate the state of his patient and designappropriate, individualized treatment. Unfortunately, because of theamount of time required to do this, diagnosis and treatment are veryexpensive.

The actual therapeutic changes in the patient occur outside of therapyas the patient applies cognitive and behavioral strategies learned intherapy to problem encountered in day-to-day situations. Progress ispredicated to a large extent on patient cooperation, discipline, andself-management. Diaries are employed to ensure patient compliance.Still, in many instances, lack of compliance to long-term therapyregimes presents a major obstacle to successful treatment. Children area particularly difficult group of patients in this respect. Frequently,they lack the understanding, maturity, and perseverance required tosuccessfully pursue a treatment plan.

In fact, it has recently been confirmed that in the case of anxiety thebest treatment involves teaching the patients new ways of responding toold stimuli. Drugs may be used to blunt the physical aspects, but thereis no data to confirm the positive effects of their long-term use.Meanwhile, treatment of depressions requires attentive counseling andlistening to the patient. The same applies to treatment of personalitydisorders, obsessive-compulsive disorders, hysteria, and paranoia.Unfortunately, cost of treatment and compliance with suggestions made bythe therapist are major problems, as pointed out above.

In difficult cases observation and comparison with criteria compiled inthe Diagnostic and Statistical Manual of Mental Disorders—the standardclassification text of the American Psychiatric Association—are the onlyrecognized treatment alternatives.

There is also a wide variety of medical conditions, other than theabove-mentioned psychological disorders, requiring extensive self-helpand self-treatment by the patient. These conditions include addictions,compulsive behaviors, and substance abuse. Most common examples aresmoking, gambling, and alcoholism. At the present time treatment forthese medical conditions involves counseling, distraction techniques,and chemical replacement therapy. Ultimately, however, all of thesemethods depend on the cooperation of the patient and a large dose ofself-motivation. This is especially important when the patient is in hisor her own surroundings where the objects of their addiction orcompulsion are easily accessible.

Unfortunately, compliance with medical advice is notoriously poor, andgentle persistence may be necessary. Some physicians recommend that theentire family or other group of significant personal contracts in thepatient's life should be involved with the patient's consent. This, ofcourse, presents major problems and is a costly treatment method.

Some attempts have been made at using computers to diagnose and educatepatients about their medical condition. Typically, these attempts haveproduced questionnaires which can be filled out on a computer, oreducational programs telling the patient more about his or her medicalcondition. Unfortunately, these projects stop short of beingsufficiently adapted to patient needs to help with treatment or therapy.In fact, health care professionals maintain that computers can neverreplace the sense of caring, of relatedness, which is the vehicle inwhich most therapy takes place.

OBJECTS AND ADVANTAGES OF THE INVENTION

Objects of the invention are to enable treatment in the patient's own,private environment, provide a treatment method to which the patient canresort as the need arises, and ensure higher treatment compliance forall patients, and in particular children.

These and other objects and advantages will become more apparent afterconsideration of the ensuing description and the accompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a schematic diagram of a remote education system according toa preferred embodiment of the present invention;

FIG. 2 is a block diagram showing the components of the remote educationsystem and how they are connected, according to FIG. 1;

FIG. 3 is a sample program assignment screen as displayed on the remoteinterface;

FIG. 4 is a sample report screen as displayed on the remote interface;

FIG. 5 is a sample interactive educational program as displayed by themultimedia processor;

FIG. 6A is a flow chart illustrating the steps executed by the fileserver of the present invention as shown in FIG. 1;

FIG. 6B is a continuation of the flow chart of FIG. 6A;

FIG. 7 is a flow chart illustrating the steps executed by the multimediaprocessor of the present invention as shown in FIG. 1;

FIG. 8 is a block diagram of an autonomous computer system employed inthe method according to the invention;

FIG. 9 is a block diagram of a computer network used in the methodaccording to the invention;

FIG. 10 is a block diagram of a system employing a hand-held:microprocessor unit for implementing the method of the invention;

FIG. 11 is a flow chart illustrating how to select an appropriate videogame treatment for some common medical conditions;

FIG. 12 is an exemplary screen of a video game for treating growthdisorders according to the invention;

FIG. 13 is another screen of the video game of FIG. 12;

FIG. 14 is an exemplary screen of a video game for diabetesself-treatment according to the invention;

FIG. 15 is another exemplary screen for the video game FIG. 14;

FIG. 16 is still another exemplary screen for the video game of FIG. 14;

FIG. 17 is a screen indicating the blood glucose measurement resultscompiled for the video game of FIG. 14;

FIG. 18A is a general flowchart of an Addiction/Distraction Video Game;

FIG. 18B is a detailed flowchart of the main game loop of theAddiction/Distraction Video Game of FIG. 18A; and

FIGS. 19-20 provide further illustrative flow charts.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

The preferred embodiment of the system is shown in FIG. 1. The system110 comprises a file server 112, which is connected by communicationlinks 138, 130, and 140 to a remote interface 114, a database 148containing educational programs, and a multimedia processor 124. Fileserver 112 is preferably a world wide web server, remote interface 114is preferably a web page, and communication links 138 and 130 arepreferably the Internet. Remote interface 114 has a display 116 and akeyboard 120, which an administrator can use to assign an educationalprogram to an individual.

Remote interface 114 also contains or is connected to a memory cardwriter 118. Memory card writer 118 is used to record the individual'sidentification code and the location of file server 112 on a memory card122. Preferably, the location of file server 112 is in the form of auniform resource locator, or URL.

Communication link 140 from file server 112 to multimedia processor 124is preferably the Internet. However, file server 112 and multimediaprocessor 124 can also contact each other via wireless communicationnetworks, cellular networks, telephone networks, or any other suitablenetwork. Multimedia processor 124 is also connected by communicationlink 132 to a display 128, which is used to show educational programs tothe individual. Communication link 132 can be any suitable connectionmeans. Display 128 is a standard audiovisual display, such as atelevision.

Multimedia processor 124 contains or is connected to a memory cardreader 126. When memory card 122 is placed in memory card reader 126,the assignment information is sent to file server 112, which retrievesthe assigned educational program from database 148. The educationalprogram content is then sent through communication link 140 tomultimedia processor 124 and shown on display 128. In addition,microprocessor 124 can also comprise expansion ports to supportadditional user interfaces and devices, such, as keyboards andtrackballs, as well as add-on circuits for enhanced sound, video, orprocessing performance (not shown).

As shown in FIG. 3, input device 134 comprising numerous momentarycontact push buttons 136 is used by the individual to control andrespond to the educational program. Push buttons 136 represent controlfunctions, such as “on” and “off”, as well as numbers, letters, orvarious commands, such as “yes” and “no”. Alternatively, push buttons136 may be replaced by switches, keys, a touch sensitive display screen,or any other data input device. Input device 134 is a standard wirelesscommunication means which sends command signals to multimedia processor124 to be processed and executed. However, any communication means whichallows input device 134 to connect with multimedia processor 124.

For clarity of illustration, only one database and only one multimediaprocessor are shown in FIG. 1. It is to be understood that system 110may include any number of databases for storing any number ofeducational programs, and any number of multimedia processors for use byany number of individuals.

FIG. 2 shows a detailed block diagram of the preferred embodiment of theinvention illustrated in FIG. 1. Server 112 includes a general softwareapplication 142 which is used create a database 144 and a patient table146. Software application 142 is also capable of programming file server112 to carry out standard commands such as receiving, saving, andtransmitting information. Database 144 contains the educational programs148. Alternatively, database 144 can contain pointers to educationalprograms 148 which are located in remote databases. The advantage of thepointers is that they allow the healthcare provider to assign any numberof educational programs 148, as long as educational programs 148 can betransmitted to multimedia processor 124 and shown on display 28. Thussuitable forms of educational programs 148 include photos, videos,animation, static web pages, interactive web pages, etc. Patient table146, which is stored in the memory of file server 112, lists thepatients, their identification codes, and educational programs 148 whichhave been assigned to them.

Patient table 146 is generated by information entered into theassignment screen 150 of remote interface 114. Assignment screen 150,which is illustrated in FIG. 3, lists available educational programs148, each with a corresponding check box 166, and patients, also eachwith a corresponding check box 168. The administrator brings upassignment screen 150 on display 116 of remote interface 114. Sheselects a check box 168 for a patient and then selects a check box 166corresponding to educational program 148 to be assigned to the patient.More than one educational program 148 can be assigned to each patient.In addition, more than one patient can be assigned the same educationalprogram 148. The administrator then selects the ASSIGN PROGRAM button170, which stores the assignment in patient table 146. Assignment screen150 also includes a DELETE PROGRAM button 172, which allows theadministrator to erase the assignment.

New listings of patients and educational programs 148 can easily becreated by the administrator by clicking on the ADD NEW PATIENT button174 or the ADD NEW PROGRAM button 176. When these buttons are selected,a new field is added to the patient or program categories. Theadministrator then types in the name of the new patient or the name ofthe new educational program 148, and saves the addition by clicking onthe SAVE NEW LISTING button 178. The new listings are then saved inpatient table 146.

In the preferred embodiment, remote interface 114 is a web page. Thus,using keyboard 120, as shown in FIG. 1, the administrator can createcustomized educational programs 148 in the form of static or interactiveweb pages for patients. The administrator creates the web page using ascripting language such as HTML or Java, and then stores it on database144. These web pages can be accessed by multimedia processor 124 in thesame manner as the above mentioned educational programs 148.

Referring to FIG. 2 again, remote interface 114 also comprises a reportscreen 152 which is shown on display 116. Report screen 152, asillustrated in FIG. 4, tells the administrator when the patient hascompleted watching assigned educational program 148 and/or a programscore. Specific techniques for writing report generator program todisplay data in this manner are well known in the art.

The program score is generally determined by evaluating the patient'sresponses to an interactive educational program, such as an interactiveweb page. FIG. 5 shows a sample educational program 148 which includesquestions for the patient to answer using input device 134.

The remote education system also includes a memory card writer 118connected to remote interface 114. Memory card writer is an apparatuswhich can encode information onto a magnetic strip or circuit. Theprocess of storing information on a magnetic strip or circuit is wellknown. Memory card 122 produced contains the patient's identificationcode 156 and the file server address 154.

As shown in FIG. 2, multimedia processor 124 also comprises a memorymeans 160, a central computing unit (CPU) 158, a modem 164, andaudiovisual display 128. Memory card reader 126, memory means 160, modem164, and audiovisual display 128 are all connected to CPU 158.Multimedia processor 124 connects to file server 112 using modem 164 andcommunication link 140, which is preferably a telephone cable.Multimedia processor 124 can be programmed to automatically dial outusing modem 164 whenever memory card 122 is placed in memory card reader126.

Memory card reader 126 comprises means of detecting and interpreting theinformation stored on memory card 122. In the preferred embodiment,memory card reader 126 is a magnetic strip reader. When the patientplaces memory card 122 in memory card reader 122, the information issent to CPU 150 and then memory means 160. The information is then sentto file server 112 by way of modem 164.

Memory means 160 of multimedia processor 124 is also for storing programinstructions on how to connect to file server 112 and how to transmitpatient's identification code 156. In addition, memory means 160receives and stores assigned educational programs 148 from file server112. When the content of educational programs 148 are sent to multimediaprocessor 124 from file server 112, memory means translate the contentinto audiovisual signals to be displayed on display 128.

FIGS. 6A and 6B show a flowchart illustrating the steps carried out byserver 112 in the preferred embodiment of the invention. In step 202,server 112 first asks if the administrator would like to create a newassignment. Creating a new assignment can mean adding a new patient tothe patient list or assigning a new educational program 148 to apatient. If the administrator decides to create a new assignment, theinformation is stored in patent table 146, as shown in step 204. In step206, the new assignment information consisting of the patient'sidentification code 156 and file server address 154 is also recorded onmemory card 122 by memory card writer 118, and then given to thepatient. If the administrator does not need to create a new assignment,she goes directly from step 202 to step 208.

After the patient returns home, he places memory card 122 in memory cardreader 126 connected to multimedia processor 124. File server address154 on memory card 122 allows multimedia processor 124 to locate andconnect to file server 112 in step 208. Patient's identification code156 is then sent over in step 210. In step 212, file server 112 thengoes to patient table 146 and looks up educational program 148 assignedto patient. A pointer in database 144 then retrieves educational program148. If educational program 148 is located in a remote database, it issent through file server 112 to multimedia processor 124, as shown instep 214. Memory means 160 of multimedia processor 124 then interpretand translate the content of educational program 148 into audiovisualsignals to be shown on display 128.

After the patient has watched educational program 148, completion datacomprising the time and date or patient responses is sent frommultimedia processor 124 to file server 112 in step 216. Step 218 scoresthe patient responses to determine a program score. Step 220 thenrecords the completion data in patient table 146 of file server 112.

If the administrator wishes to view completion data of a particularpatient, she can request a patient report, as shown in step 222. Step222 can occur after the patient has watched and responded to educationalprogram 148 in step 220, or at any time after step 208. File server 122retrieves the patient's completion data from patient table 146, step224, and then shows it in the form of report screen 152 on display 116in step 226. Report screen 152 is illustrated in FIG. 4.

FIG. 7 is a flowchart outlining the steps involved in the processorprogram of multimedia processor 124 in the preferred embodiment of theinvention. Processor program can be carried out by known softwareprograms. The processor program begins when memory card 122 is placed inmemory card reader 126, as shown in step 302. Memory card reader 126reads patient's identification code 304 and file server address 156 frommemory card 122 in step 304, and then sends the information to CPU 158.File server address 154 allows CPU 158 to connect to server 112 viamodem 164 in step 306. Patient's identification code 156 is thentransmitted to file server 112 in step 308. In step 310, CPU 158receives the content of assigned educational program 148 via modem 164.The content is converted into audiovisual signals shown on display 128in step 312. Patient response to educational program 148 is sent to CPU158 by input device 134. CPU 158 then sends the patient response, alongwith other completion data, to file server 112. The processor program ofmultimedia processor 124 then ends.

Memory card reader 126 of multimedia processor 124 can also have awriting function similar to that of memory card writer 118 of remoteinterface 114. This feature allows the patient responses to educationalprogram to be stored on memory card 122. The patient can then bring inmemory card 122 to his healthcare provider or the administrator. Memorycard writer 118 of remote interface 114 must also have readingcapabilities. Memory card 122 is inserted in memory card writer/reader118 and the patient responses are downloaded into remote interface 114.This feature can be used if the patient does not wish to transmit hisresponses over communication link 140.

The present invention allows a healthcare provider or administrator toassign a remote educational program to a patient. The patient has theluxury of watching and responding to the program in his own home at hisconvenience. The patient's response to the educational program is thentransmitted to the file server and displayed for the administrator toview. Thus the administrator can monitor whether or not the patient haswatched the educational program, and can also evaluate his responses tothe program.

Appendix A shows one implementation of the present invention as itapplies to working with a diabetes patient through MEDTV.™ over theInternet. MEDTV.™ is a trademark of Raya Systems, Inc. (Mountain View,Calif.).

SUMMARY, RAMIFICATIONS, AND SCOPE

Although the above description contains many specificities, these shouldnot be construed as limitations on the scope of the invention but merelyas illustrations of some of the presently preferred embodiments. Manyother embodiments of the invention are possible, as this invention canbe used in any field where it is desirable to remotely educate anindividual. For example, teachers can use it to assign lessons to theirstudents, and employers can use it to provide additional job trainingfor their employees.

Another embodiment of the present invention allows companies to promotetheir products. Preprogrammed memory cards can be placed with acompany's products. When the consumer buys a product, he also receivesthe preprogrammed memory card, which contains the product identificationcode and the address of the company's consumer-product file server. Whenthe consumer places the memory card in the memory card reader of hismultimedia processor, the multimedia processor automatically connects tothe company's file server. The file server contains a consumer-producttable which stores a list of all the company's products withcorresponding pointers to relevant educational programs oradvertisements. For example, a sunblock product would have a pointer toa short video on basic sun safety, as well as an advertisement for allsunblock products made by that company.

When the file server receives the product identification code from themultimedia processor, it retrieves the relevant educational program oradvertisement and sends it back to the consumer's multimedia processor.The consumer can then watch the program or advertisement on the display.

Considering all the possibilities of the remote education system, thescope of the invention should be determined not by the examples given,but by the appended claims and their legal equivalents.

FIG. 8 shows a block diagram representing a typical embodiment of acomputer or microprocessor-based unit 410 capable of supporting videogames for patient treatment. At the heart of unit 410 is amicroprocessor 412. In addition to operations necessary to run unit 410,microprocessor 412 can process video data. Of course, in complicatedsystems the tasks of microprocessor 412 can be performed by a number ofmicroprocessors. In the most preferred embodiment microprocessor 412 isa SUPER NINTENDO™ microprocessor.

A display unit or screen 414 is connected to microprocessor 412. Theresolution and size of display screen 414 are sufficient to projectvisual images generated by video games. In a preferred embodiment screen414 is a high-resolution video monitor or television screen. A speaker415 for producing sounds associated with video games is hooked up tomicroprocessor 412 as well.

A patient input device 416 is also connected to microprocessor 412.Input device 416 can be a keyboard, joystick, mouse, button, trigger,light-pen, or the like, or combinations of these devices. A suitablechoice of input device 416 is made based on the video game displayed ondisplay screen 414 and the medical conditions of the human patient. Theselected input device 416 will thus permit the patient to activelyparticipate in the video game.

Additionally, microprocessor-based unit 410 has a memory 418, which isin communication with microprocessor 412. Memory 418 contains datarequired by microprocessor 412 to operate unit 410. While in theexemplary embodiment illustrated in FIG. 8 memory 418 consists of asingle unit, configurations with many memory units of different typesare possible.

Unit 410 is also connected to a digital storage medium 420 andappropriate data reading devices (not shown). Digital storage medium 420can be a hard-disk, a floppy disk, a compact disk (CD), a cartridge, anetwork storage unit, or any other convenient medium capable of storingelectronic instructions for running a video game on unit 410. In thepreferred embodiment storage medium 420 is a high-storage-capacity CDdisk. The ability to hold a large amount of data is a prerequisite forstoring large video game programs.

FIG. 9 is a block diagram of a computer network for practicing the videogame treatment method. Individual microprocessor-based units 410 on thecomputer network are substantially the same as in FIG. 8, therefore thesame reference numbers are used for corresponding parts. Instead ofdigital storage medium 420, units 410 in FIG. 9 have a network interface422 equipped with a network link 424. Link 424 connects microprocessor412 to network 426 via interface 422. In a preferred embodiment network426 is a separate hospital network adapted to patient use.

On the hospital side network 426 is connected to a hospital networkserver 428. Server 428 is capable of exchanging data, in particularvideo game data, with each unit 410 connected to network 426. Server 428is also connected to computers used by monitoring personnel andphysicians at the hospital (not shown).

The block diagram of FIG. 10 shows a particularly convenient embodimentfor implementing the diagnosis and treatment method. A hand-heldmicroprocessor unit 430 is equipped with a video display 434 and anumber of input switches or keys 436 a, 436 b, 436 c, 436 d, and 436 e,which are mounted on a housing 432. A set of components including amicroprocessor, memory circuits, and circuitry that interfaces keys 436a, 436 b, 436 c, 436 d, and 436 e with the microprocessor is installedinside housing 430 but not shown in FIG. 10. Stored in the memory ofprogrammable hand-held microprocessor unit 430 is a set ofelectronically encoded program instructions. These instructionsestablish a data protocol that allows hand-held microprocessor unit 430to perform digital data signal processing and generate desired data orgraphics for display on display unit 434 when a program cartridge 438 isinserted into a slot or other receptacle in housing 432. That is,cartridge 438 of FIG. 10 includes read-only memory data encoding theinstructions for playing a particular video game.

In the most preferred embodiment hand-held microprocessor unit 430 isthe compact game system manufactured by Nintendo of America, Inc. underthe trademark “GAME BOY”. This device is particularly simple.Furthermore, unit 430 is hooked up to a remote communication unit 442via a connection cable 440. Preferably, for reasons of convenience, unit442 can be a modem capable of communicating over telephone lines, or aradio-frequency transceiver capable of wireless sending and receiving ofinformation. Of course, any other common telecommunications devices canalso be used. It is assumed in the preferred embodiment shown in FIG. 10that unit 442 is a high-speed modem.

A communication line 444, in this event a telephone line, connects unit442 to a data clearing house 446 and hospital computer 452. This set-upestablishes an efficient data pathway from hand-held microprocessor unit430 to clearing house 446 and hospital computer 452. Clearing house 446is capable of classifying data and sending appropriate messagesconcerning the patient's medical condition to a health care professionalor physician. In the preferred embodiment clearing house 446 isconnected by transmission line to a facsimile machine 450 standing inthe office of a physician or health care professional.

A physical parameter measuring device 454, e.g., a glucose blood meteror a respiratory flow meter is also connected to hand-held unit 430.Device 454 is designed for patient self-monitoring while playing a videogame. For this purpose device 454 is capable of downloading measurementdata into hand-held unit 430. Appropriate choice of device 454 is madeby the physician depending on the other hardware and intended video gamefor patient treatment.

Operation—FIGS. 8 to 17

Before using microprocessor-based unit 410 shown in FIG. 8, a patientwill first visit a physician or health care professional to evaluate hisor her medical condition. The physician will diagnose the condition andchoose the proper treatment based on patient needs. The flow chart inFIG. 11 shows the psychological strategies which the physician canselect for treating depression, attention deficit, addiction, anddiabetes. The psychological strategies listed include self-awarenesstraining, self-efficacy training, competition, communication, anddistraction. Of course, other well-known strategies such as positivereinforcement, negative reinforcement, role-playing, etc. can beemployed as well. In addition to these, the psychological treatmentstrategy can include counseling methods and self-care instructions.Moreover, the treatment strategies can be combined as shown For example,as shown in FIG. 11, overcoming depression is best ensured by a therapywhich joins self-awareness training with learning self-efficacy toregain control over one's life. In the particular case highlighted withtwo arrows the medical condition to be treated is an addiction, e.g.,smoking or alcoholism, and the appropriate psychological strategy fortreating this condition is distraction.

Once the psychological treatment strategy has been selected, thephysician will choose an appropriate interactive video game programcomprising this strategy. Examples of video games based on the mostcommon psychological strategies will be given in the specific examplesto follow. Meanwhile, the program itself consists of electronicallyencoded instructions in data storage medium 420 (FIG. 8). The video gameprogram is loaded from this medium 420 into microprocessor 412 andmemory 418 of unit 410. In the preferred embodiment this is accomplishedmost conveniently by a CD disk drive (not shown) since digital storagemedium 420 is a CD disk. The patient receives unit 410 prepared in thisway and is instructed by the physician how and when to play the videogame. Of course, the physician may also load several video games at onceand instruct the patient when to play each one. Depending on the type ofvideo game and the patient's capabilities, the physician will alsodetermine what patient input device 416 should be employed in playingthe game.

The patient takes home unit 410 prepared in this manner, and follows theprescribed treatment by playing the video game. Once in operation, unit410 displays the graphical video game on display screen 414 and receivesinput through patient input device 416. The beneficial effect of playingthe game is thus available to the patient at any time in his ownenvironment.

The process described above can also be accomplished with the computernetwork shown in FIG. 9. Here, appropriate treatment programs can beloaded directly into unit 410 used by the patient while he is at home.To do this the physician selects the appropriate video game, determinesits destination address, i.e., unit 410, and places the game on hospitalnetwork server 428. The designated unit 410 then retrieves the videogame via network 426 and loads it into microprocessor 412 and memory418. This is done with the aid of network link 424 and interface 422.

A particularly convenient method for delivering a video game to thepatient is shown in FIG. 10. Hand-held microprocessor unit 430 receivesvideo games directly from hospital computer 452. The video game istransmitted through communication line 444 and received by remotecommunication unit 442. Unit 442 downloads the game directly intohand-held unit 430 via connection cable 440.

Hand-held unit 430 in FIG. 10 also communicates with clearing house 446using communication line 444. Thus, the patient's progress in playingthe video game can be directly monitored, e.g., by checking the videogame scores. This information is screened, classified, and sorted byclearing house 446. Then an abstract or report is transmitted throughtransmission line 448 to facsimile machine 450 which can be convenientlylocated in the physician's office.

Unit 430 shown in FIG. 10 can also be used by the patient to check hismedical condition. To do this the patient follows instructions embeddedin the video game which tell him to connect to unit 430 his measuringdevice 454, e.g., blood glucose meter in the case of a patient withdiabetes. Of course, unit 430 and device 454 may also be hooked uppermanently by the physician. Then the video game instructions tell thepatient that to continue playing he needs to perform a regularself-measurement using device 454.

For a patient with diabetes this involves checking his blood glucoselevel by drawing a small blood sample into device 454. The individualsteps for doing this are not a part of the invention. The measurementdata is then downloaded into hand-held unit 430 to be used as input forthe interactive video game session. Exemplary video game using thistechnique to collect data is described in example 4 below. Meanwhile,the blood glucose data is also passed through cable 440 to remotecommunication unit 442. From there the data follows the same path asdescribed above for the video game score, and can be examined by thephysician in the hospital.

The specific examples below describe exemplary microprocessor-based,interactive video games used for treating various medical conditions inhuman patients.

Smoking

EXAMPLE 1

The patient has a severe case of nicotine addiction. The physiciandetermines, according to the flow chart in FIG. 11, that distraction isthe best psychological strategy to induce the patient to quit smoking.Therefore, the physician prescribes playing the Quit Game, a video gamecontaining a behavioral program based on distraction. This game containsgraphical game characters engaging in various competitive activitiesupon proper input from the user. The smoker plays the game is playedwhenever he or she feels the urge to smoke. An exemplary game to providesuch engaging distraction is shown in the flowchart illustrated in FIGS.18A and 18B. In this particular embodiment the game distracts the playerwith falling bricks which have to be arranged in rows. During the gamethe main characters communicate to the patient instructions and simplestrategies to quit smoking immediately and advise the user to take thisapproach, all within the context of the entertaining video game.

Alternatively, the game provides a timer and timeline for gradualreduction approaches to smoking cessation. Included among these programsare instructions for using nicotine patches. Built in notification willserve to remind smokers to shift to a lower dose patch. Once the smokerhas quit, the video game will provide a coping/relapse prevention modelby using distraction methods during periods of smoking urges.

A pilot study using the NINTENDO GAME BOY® as a tool to aid smokingcessation was highly successful. In the pilot project, seven smokerswere give a Game Boy portable loaded with the Quit Game and instructedto use it any time they felt the urge to smoke. Six of the seven smokerssuccessfully quit and were very enthusiastic about this approach.

An analogous video game strategy is followed in dealing with othersubstance abuse conditions, alcoholism, and obsessive compulsivedisorders.

Growth Disorder

EXAMPLE 2

The physician diagnoses the patient with a growth disorder, such asTurner's Syndrome or a similar condition, requiring growth hormonetreatment and a psychological treatment strategy for helping the patientcope with his or her condition. By following a selection process similarto the one indicated in FIG. 18A-18B, the physician prescribes a videogame combining self-awareness training, self-efficacy, role-playing,counseling and competition. The flowchart of the Growth Game is providedin FIG. 19.

In the video game the graphical game character, Packy, is a youngelephant who, like the patient, is on growth hormone therapy. The videogame consists of three pans, each associated with a particular aspect ofthe treatment. In the first part Packy encounters obstacles which hemust surmount, in the second he has to learn about growth hormoneinjections, and in the third one he has to keep a personal growth diary.

In the first part Packy learns about things that grow, from the smallestthings in the world to the largest ones. In each level of this partPacky can pick up icons of OM (representing a growth hormone shot) for aboost of energy. When he gets this boost, he will grow to a larger sizeuntil the energy wears or he gets hit by one of his opponents. Everytime Packy meets someone who challenges him he must push them away bypressing a button to lower his head and walking into them, or squirtthem by pressing another button. The small antagonists push and squirtaway easily, but the large ones require some strategy such as combiningpushing and squirting. This stage is depicted in FIG. 12. In each levelPacky will occasionally find obstacles that require a growth shot to getpast. He will also occasionally encounter a guardian to the pathway thatasks him questions from the information learned in the other two parts,i.e., the growth hormone injection instructions and the personal growthdiary.

In another level of part one Packy has a dream in which he explores theworld as a tiny creature. This scenario is illustrated in FIG. 13. Hefinds that he is very small himself, while all the surrounding items arevery large. As he works his way to the end of this level he willencounter all types of animals and insects that are very small. Thislevel will give Packy a feeling for what it is like to be really small.In the transition to the next level, Packy will wake up and see that heis still the same size, and grateful that he is not so small.

In the final level, Packy finds himself very large. He will be with thegiant animals of the world. As he works his way through this level hewill encounter all types of animals that are very large and the varioustypes of obstacles they face in daily life. When Packy is bigger thanthe biggest elephant and cannot enter his home, he begins to realize theproblems of being big.

Throughout his quest to feel comfortable with his growth, Packy isaccompanied by his mosquito sidekick Zippy. His companion plays the roleof a mentor and counselor throughout the various levels of Packy'sadventures.

In part two the patient will learn about preparing and administeringdoses of growth hormone. First, the user will see how to mix a dose,then prepare a pen for injecting the hormone, and then actually see howan injection is performed. In the game aspect of this part the user willbe challenged to mix and administer a dose seven times (Monday throughSunday) and provide accuracy results.

The third part of the game is a growth diary where the patient recordsand sees various graphics displaying his or her personal progress.

Playing this game is reassuring and helps children overcome growthdisorders by emphasizing self-awareness and self-efficacy training,role-playing, competition, and strategies embedded in the video game.Analogous video game strategy is also used to treat anxiety andhyperactivity disorders, various types of phobias, as well as enuresis.

Diabetes

EXAMPLE 3

The patient is diagnosed with insulin-dependent diabetes. As treatmentthe physician prescribes insulin shots and a video game based onpositive-reinforcement and self-management. In the video game thegraphical game character is a pilot who has diabetes, just like thepatient. The pilot needs to follow proper diet and exercise regimen toavoid crashing a plane or balloon which he is flying. The screens forthe video game are shown in FIG. 14 and FIG. 15. The flowchart for thisgame is shown in FIG. 20. Eating wrong foods causes blood glucose levelto increase and the plane or balloon starts gaining altitudeuncontrollably. Eventually, above a certain threshold, the balloon orthe plane spins out of control.

During the game the patient is requested to enter his own blood glucoselevel by using blood glucose meter 54. An exemplary set-up for doingthis is shown in FIG. 16. The reading is used in the game and can alsobe transmitted to the hospital, as described in example 3. Also, theuser can view his blood glucose readings in the form transmitted to thehospital and used in the game. An example of such reading for a numberof measurement records is illustrated in FIG. 17.

If the user does not comply with the request for measuring and enteringhis blood glucose level the plane or balloon disappears behind clouds,representing uncertainty in blood glucose level. This is visualized bythe clouds in FIGS. 14 and 15. The clouds obscure the pilot's vision andlead to collisions with objects in the plane's or balloon's path.Alternatively, if the blood glucose level drops below a minimumthreshold, the plane or balloon crashes against the ground.

This positive reinforcement-based strategy, in which the blood glucoselevel is correlated to a game parameter, e.g., plane altitude, teachesthe patient how to cope with his condition on a day-to-day basis whilemaking blood glucose monitoring fun. It also produces higher treatmentcompliance rates, especially in children who need to learn early onabout proper diabetes self-management.

Non-Insulin Dependent Diabetes Management

EXAMPLE 4

A video game treatment can be used for management of non-insulindependent cases of diabetes (NIDDM). In such cases the video game is aninteractive information resource, as well as a role-playing game. Thegame helps the patient, especially an adult patient, explore the topicof Staged Diabetes Management. The information is presented in hypertextformat, allowing the patient to select a stage, read a brief overview ofit, and select details to examine it in greater depth in desired. Thegame encourages active involvement in learning and providesopportunities to rehearse various health behaviors and see theconsequences that result by observing what happens to a graphical gamecharacter who displays these behaviors.

The content of the game is based on the Staged Diabetes Managementprogram, developed by the International Diabetes Center and BectonDickinson & Company. The progressive set of stages ranges from least tomost severe. For example, a patient in Stage I will learn to manageNIDDM through diet alone.

In the video game the user can configure the graphical game character inmany ways. A checklist of chokes allows the patient to combine a varietyof physical features and clothes, as well as specifics about thecharacter's health status including weight, age, and medications taken.

The game character, and thus the patient, will make decisions inrealistic settings such as restaurants and parties where rich foods areavailable. Also, an exercise plan will fit in with the character's busyschedule of family, community, and work commitments. This formatprovides the patient with a playful atmosphere in which choices whichthe patient faces in his or her own life can be rehearsed.

If blood glucose levels do not remain in the normal range in Stage I,then the patient is instructed by the graphical game character toadvance to the next treatment steps, eventually arriving at the stagewhere the patient will be instructed to inject insulin to control bloodglucose levels. The goal of the NIDDM game is to remain at Stage I.

Similar video games can help to deal with hemophilia, and other medicalcondition requiring the patient to be aware of his or her surroundings.

Asthma

EXAMPLE 5

A youngster diagnosed with asthma is given an asthma self-managementgame for hand-held unit 430. The graphical game character, a youngdinosaur from the pre-historic town of Saurian, must cope with andmanage his asthma. The game San character confronts common asthmatriggers, while learning to recognize early warning signs of an oncomingasthmatic episode. Asthma management techniques including avoidance,relaxation, and medicinal inhalers are part of the daily routine for theyoung dinosaur who must return to his cave. The dinosaur runs, jumps,and shoots a squirt gun at oncoming triggers while conquering each leveland mastering his condition. In addition to these inputs, the dinosaurrequests the player to input the player's asthma condition by usingphysical parameter measuring device 454, which in this case is arespiratory flow meter. These data can then be transmitted to thephysician as described above.

Playing the video game involving these real asthma triggers, relaxationtechniques, etc., affects the mental state of the player to improve hisown asthma management outside of video game sessions. This treatmentbased on role-playing and positive reinforcement makes the patient awareof the importance of prescribed drugs and teaches appropriate measuresfor dealing with the patient's condition in real life situations.

Eating Disorder

EXAMPLE 6

The physician determines that the patient suffers from an eatingdisorder causing the patient to gorge. The physician loads into thepatient's microprocessor-based unit 410 or hand-held unit 430 a videogame in which the graphical game character has to stay thin to survive.The game challenges confronting the game character include avoidingfatty foods to stay trim and eating a sufficient amount to combatdragons and surmount obstacles on his way. Doing this involves makingchoices about what food presented on the screen to eat, keep for later,or reject. Wrong food choices have immediate consequences in thegraphical character's ability to survive. The game is scored accordingto the length of time the patient is capable of keeping his gamecharacter alive and obstacles the character overcomes.

The physician instructs the patient to play the game every time thepatient feels an eating urge outside regular meal times. During aregular follow-up visit the doctor evaluates the patient's progress andchecks the scores obtained in playing the video game. Based on theanalysis of the sores the physician determines the severity of theproblem and gets an insight into the patient's motivation to comply withthe therapy. Sufficiently high scores reflect progress and readiness toproceed with the next treatment stage. At this point the physician mayinstruct the patient to play another video game designed for mildereating disorders or a game utilizing a different psychological approach,e.g., negative reinforcement or distraction.

Depression

EXAMPLE 7

A psychiatrist enrolls a patient in a series of home-based interactivevideo game sessions, which the patient accesses from hismicroprocessor-based unit 410 through hospital network 426. The videogame is then transmitted from the hospital network server 428 to thepatient's unit 410. The game involves interaction with a graphical gamecharacter resembling the Yoda character from the popular movie “StarWars”. Yoda acts as a counselor and mentor to the patient, preparing himfor various trial episodes in the video game. Based on patient's scoresin playing the video game sent, the physician reviews how the patientresponds to video game counseling and prepares another game to betransmitted to the patient. This treatment method is part of an on-goingtherapy for mild to medium-severe depression. This approach is also usedfor schizophrenia and other purely psychological disorders.

SUMMARY, RAMIFICATIONS, AND SCOPE

The reader will thus see that I have presented a particularly simplemethod for treating medical conditions in human patients using amicroprocessor-based video game. This method gives a better picture ofthe ailment through its standardized scoring procedure and makes thetreatment much less costly by considerably reducing the number oftherapy sessions with the physician or health care professional. Inaddition, video games emphasize superior treatment in the patient's ownenvironment. This leads to self-help responses difficult to foster intherapy sessions. The patient recognizes the importance of medicationsand treatment regimens in an entertaining manner. Moreover, the patientparticipates actively in the treatment by following instructionsembedded in the video game or even generating positive physiologicalresponses due to stimuli presented in the video game.

The method of the invention also provides a treatment to which thepatient can resort as the need arises. The intrinsic fun in playingvideo games ensures higher treatment compliance for all patients, and inparticular children. The self-treatment instructions communicated bythis method can be used to additionally induce patients to independentlyperform measurements of physical parameters associated with theirmedical condition.

Finally, the scoring of the video game provides an excellentstandardized measure for evaluating treatment results and improvingcontinued treatment. In carrying out the method the microprocessor-basedsystem can be expanded to use any number of communications devices,monitoring set-ups, and other state-of-the-art medical equipment.Therefore, the scope of the invention should be determined, not beexamples given, but by the appended claims and their legal equivalents.

1. A method of diabetes management, comprising: (a) providing acommunications unit remotely located from and in communication with aportable microprocessor-based unit; (b) advising a user to measure ablood glucose level by transmitting blood glucose level data into theportable microprocessor-based unit or the communications unit, or both;(c) running a program of instructions on the portablemicroprocessor-based unit or on the communications unit, or both, usingdata corresponding to the blood glucose level data, wherein saidportable microprocessor-based unit comprises a multi-line displayconfigured to present to said user (i) graphs of said blood glucoselevel data and (ii) a game-like presentation; and (d) advising said userto inject insulin according to an insulin plan; (e) presenting to saiduser (a) said blood glucose level data and (b) information to educatesaid user regarding management of diabetes; (f) receiving from said userresponses confirming said blood glucose level has been measured; and (g)positively reinforcing compliance with a diabetes management plan byproviding bonuses in said game-like presentation on said multi-linedisplay in response to said blood glucose level being within an optimalrange.
 2. The method of claim 1, further comprising signal coupling ablood glucose meter with said portable microprocessor-based unit fromwhich said blood glucose data are downloaded.
 3. The method of claim 1,wherein (i) said program of instructions comprises a diabetes managementplan and (ii) further comprising communicating a signal to said portablemicroprocessor-based unit to advance between steps of said diabetesmanagement plan.
 4. The method of claim 1, further comprising checkingsaid blood glucose level as a result of running the program ofinstructions.
 5. The method of claim 1, further comprising selectingsaid insulin plan as a result of running the program of instructions. 6.The method of claim 1, further comprising getting a menu of foods to eatas a result of running the program of instructions.
 7. The method ofclaim 1, wherein said program of instructions are configured such thatsaid advising said user to inject said insulin occurs when said bloodglucose levels do not remain in a predetermined range.
 8. One or moreprocessor-readable storage devices having program code embodied thereinfor programming one or more processors to perform a method of diabetesmanagement using a system including a communications unit remotelylocated from and in communication with a hand-held microprocessor-basedunit, wherein the method comprises: (a) advising a user to measure aglucose level; (b) providing blood glucose level data based on themeasured glucose level into the hand-held microprocessor-based unit; (c)running a program of instructions on the hand-held microprocessor-basedunit or on the communications unit, or both, using data corresponding tothe blood glucose level data, wherein said hand-heldmicroprocessor-based unit comprises a multi-line display configured topresent to said user (i) graphs of said blood glucose level data and(ii) a game-like presentation; and (d) advising said user to injectinsulin according to an insulin plan; (e) presenting to said user (a)said blood glucose level data and (b) information to educate said userregarding management of diabetes; (f) receiving from said user responsesconfirming said glucose level has been measured; and (g) positivelyreinforcing compliance with a diabetes management plan by providingbonuses in said game-like presentation on said multi-line display inresponse to said glucose level being within an optimal range.
 9. The oneor more processor-readable storage devices of claim 8, wherein themethod further comprises signal coupling, a blood glucose meter withsaid hand-held microprocessor-based unit from which said blood glucosedata are downloaded.
 10. The one or more processor-readable storagedevices of claim 8, wherein (i) the program of instructions comprisessaid diabetes management plan and (ii) the method further comprisescommunicating a signal to said hand-held microprocessor-based unit toadvance between steps of said diabetes management plan.
 11. The one ormore processor-readable storage devices of claim 8, wherein the methodfurther comprises checking said glucose level as a result of running theprogram of instructions.
 12. The one or more processor-readable storagedevices of claim 8, wherein the method further comprises selecting saidinsulin plan as a result of running the program of instructions.
 13. Theone or more processor-readable storage devices of claim 8, wherein themethod further comprises getting a menu of foods to eat as a result ofrunning the program of instructions.
 14. The one or moreprocessor-readable storage devices of claim 8, wherein said advisingsaid user to inject said insulin occurs when said glucose levels do notremain in a predetermined range.